Red blood cell production is by far the main consumer of iron in the body. The existence of hormones that regulate iron in response to the needs of red blood cell production was proposed more than 50 years ago.
Erythroferrone (ERFE) is a hormone produced by erythroblasts in the bone marrow in response to erythropoietin (EPO). Recent animal studies have shown that rather than being involved in regulation of baseline erythropoiesis, ERFE acts as a stress erythropoiesis-specific regulator of hepcidin expression. High hepcidin expression leads to inhibition of absorption of dietary iron and the sequestration of iron in macrophages and hepatocytes. By suppressing hepcidin expression in the liver, ERFE contributes to increased dietary iron absorption and recycling of stored iron necessary for recovery of blood mass after hemorrhage. In addition, ERFE was found to be involved in hepcidin regulation in inherited iron loading anemias, such as β-thalassemia. ERFE has potential as a clinical marker for assessing erythropoiesis in patients with blood disorders.
To date, there have been no reports of a human ERFE assay in development and/or validation.